It is sometimes contended that the majority of women have a slightly odd relationship with food. Many adult women are guilty of passing on mixed messages about food to younger generations. This very type of thinking is constantly, if unwittingly, being passed on to our children, nephews, nieces and young friends - which has helped to increase the feelings of ambivalence about food in today's society.

Many adult women are guilty of passing on mixed messages about food to younger generations. But on top of that, we now live in a very 'beautiful people' kind of world where television, magazines and newspapers continually bombard us with images of extremely slim people. This is undoubtedly a bad thing, but the fact is that most of us, deep down, equate slimness with success. Small wonder then that there is an increasing number of children as young as 11 who are on diets.

And we're not alone in our unnatural obsession with food and weight. It's interesting to note - and very sad too - that as our kind of 'civilisation' spreads to the farthest corners of the world, so the desire for the perfect body spreads too. One recent study found that when television reached the Fiji islands, it wasn't long before the young women there became so concerned about their figures - for the first time - that 15 per cent of them began to induce vomiting as a means of controlling their weight.

When does dieting become an eating disorder?

Plenty of people who occasionally go on a diet are mentally healthy and certainly don't have eating disorders. And there are vast numbers of adults who are carrying a stone or two more than they should who have nothing wrong with them except for the fact that they take in more calories than they use up.

And what of the women who have a funny kind of love/hate relationship with food? Well, their attitudes are certainly unhelpful, but most of them don't actually develop full-blown eating disorders.

So what is an eating disorder? It is an outward sign of inner problems. As the Eating Disorders Association says: 'an eating disorder occurs when eating or not eating is used to help block out painful feelings.' The Eating Disorders Association also says that without appropriate help and treatment, such difficulties may persist throughout life.

How widespread is the problem?

There is absolutely no doubt that eating disorders are on the increase. The Eating Disorders Association believes that 1.15 million people in this country have a significant problem and that between 60,000 and 90,000 of those are having treatment.

Indeed the scale of the problem is such that every GP in the land is likely to have one or two anorexics among his or her patients, and no less than 18 bulimics. However, most GPs don't identify all these people as having eating disorders because of the secret nature of these conditions.

Compulsive or binge-eating is also classed as an eating disorder but far fewer studies are done about these people. And when compulsive eaters - who are sometimes extremely overweight - do visit their doctors they are likely to be given a diet sheet rather than offered any kind of counselling which might get to the root of the problem.

When we talk of eating disorders we tend to think 'female'. But it's important to recognise that nowadays about 1 in 10 people who have an eating disorder is male. And it appears that of those men with eating disorders, 25 per cent of them are gay. It's also been discovered that the vast majority of these males, if not all of them, were bullied at school.

Causes

One reason appears to be poor self-esteem. Certainly many eating disorders begin when young people become convinced that if only their bodies were more perfect, they would feel better about themselves.

There are also issues of control. If young people are bullied, or even just living in bossy or super-achieving households, they can easily feel that everyone else controls them. To counter that, they seek out some way in which they can be certain of exerting some real control of their own. And many of them choose to have ultimate control of their own bodies by rigidly governing how much food they'll allow to pass their lips. The sense of power can be very elevating - at least initially - and having had this kind of excited 'fix', most young people are reluctant to relinquish it.

Another cause of eating disorders is undoubtedly media pressure at a time when a young person is feeling vulnerable and awkward. But there is some suggestion that a person's genetic make up may make them more prone to eating disorders than other folk are.

Unfortunately, some young people suffer traumatic events such as bereavement or sexual abuse in their early years and there is substantial evidence that such episodes can trigger problems with food.

Also, households where there are high academic expectations are well-known breeding grounds for eating disorders.

Finally, many young women between the ages of 15 and 25 develop an eating disorder when they are not only under stress at school or college but also uncertain of their sexual orientation or sexual attractiveness.

Excessive exercise

In the case of some youngsters - notably young men - the emphasis of the disorder is on excessive exercise rather than on food. Indeed many guys nowadays are 'addicted' to exercise.

At first sight an excessive exerciser will look extremely fit. So much so that his friends, parents or GP will be unlikely to spot the problem until it's got completely out of hand. However some doctors are particularly clued up about this kind of syndrome and they're likely to pick up on it when a patient keeps presenting with sports injuries.

Eating disorders - the facts

Anorexia nervosa

Anorexics restrict the amount they eat and drink - often to dangerous levels.

The average age of onset for anorexia nervosa has been reported to be between 16.6 and 18.3 years.

Anorexics often come from families where there is not much communication but where there is considerable pressure to perform well or to 'be perfect'.

In anorexia there's a refusal to maintain weight at a normal level.

Anorexics have an intense and growing fear of gaining weight or of becoming fat

As time goes by, an anorexic loses a proper perspective or his or her own weight, frequently believing that he or she is much bigger than reality.

Anorexic girls can become so seriously undernourished that their periods stop and downy hair appears on their bodies.

Anorexics frequently have mood swings.

Anorexics will often have dizzy or fainting spells and will usually feel cold.

Bulimia Nervosa

A bulimic has an uncontrollable urge to eat vast amounts of food.

Bulimics have an emotional hunger that cannot be satisfied.

Bulimics binge then vomit, or use laxatives or diuretics, as a means of controlling weight.

Bulimics are frequently of normal weight.

Bulimics often suffer from mood swings.

Bulimics sometimes have abrasions on the back of one hand. This happens because their teeth graze that hand whenever they stick their fingers down their throat to induce vomiting. This tell-tale sign can be useful for friends, parents or doctors in identifying the problem.

Bulimics frequently have sore throats because of their constant vomiting. This again is a symptom that may help doctors identify the problem of bulimia in their patients.

Bulimics develop problems with tooth decay - this is because of the acid in their vomit constantly washing over their teeth. Dentists are often the first people to spot this problem and sometimes confront the bulimic with their suspicions and encourage her to seek treatment.

Bulimics eat to gain emotional satisfaction but as they start to feel full they are overcome by feelings of guilt and shame.

In severe cases, the bulimic can develop dangerously low levels of essential minerals in the body that can badly affect - sometimes fatally - the vital organs.

Occasionally, severe bulimia can lead to heart attacks.

Compulsive/Binge-Eating

Compulsive eaters indulge in regular but episodic over-eating of large amounts of food that are perceived to be fattening.

They will:

think obsessionally about food and weight

will indulge secretly

have a sense or feeling of being out of control but will be able to delay the binge until alone